Welsh Liberal Democrats

Dignified Care

Peter Black: I welcome the opportunity to debate this motion and report today. The motion has been tabled in aparticularly timely manner. The original report made for very grim reading and there can be no doubt that the treatment of older people in our hospitals must be improved. Julie Morgan was also right to say that this report underlines the fact that we achieve the best outcomes for older people if we are able to keep them in their own homes for as long as possible. There is therefore a clear need to redesign our social and community care services.

The report also underlines the importance of the way in which we plan for people to leave hospital and reintegrate into their communities, because not everyone who is admitted to hospital is being admitted until the end of their lives. Many older people go into hospital and leave at the earliest possible opportunity, but they may be held up in hospital for longer than necessary because the support is not in place to enable them to go back to their own homes. We do not have properly funded reablement services in place in every part of Wales and the need for consistency across Wales with regard to reablement is paramount. There are also physical challenges regarding the transition from hospital to home. The longer an older person is in hospital, the more difficult it is to readjust to return to their home. Therefore, there is a need to ensure that older people have access to community transport, that the necessary adaptations have been undertaken in their homes, and that befriending services are provided so that they do not feel lonely or isolated after returning home. These are the types of vital services needed as part of a strategy to deal with the issues raised in this report.

I accept that the Government is taking action to ensure the urgent implementation of the report's 12 recommendations, and, like Nick, I am looking forward to hearing the Minister's full response to the report with regard to what exactly is planned to be done. The Minister has announced a number of new measures in the past few days, including a cash injection for orthopaedic services that will benefit our older population, and a number of care programmes. However, what is not clear, and I would be grateful for some clarification, is how these measures will work in practice, and how they will be delivered and monitored. For example, while the dementia training programme is to be welcomed, page 71 of 'Dignified Care?' states that,

'the training needs of staff are not assessed and even where these are obvious, the ability to release them from ward duties for training is apparently very limited due to pressure of work.'

The commissioner's second recommendation states that there remains a need for further more specific examination of dementia care in acute and community hospitals, as well as in specialist mental health facilities. It would be helpful to know whether the Minister intends to wait for the outcome of the commissioner's assessment of all the received responses and then implement an integrated approach to dementia, or whether the Government's newly announced programme is a separate issue that will be put in place irrespective of that further work by the older people's commissioner. There needs to be a clear and costed delivery plan for any proposed measures to ensure their successful delivery and to prevent any gap between policy and implementation. I would also expect there to be regular monitoring and reporting. I have no doubt that, once the relevant scrutiny committees of the Assembly are up and running, they will want to revisit the action plans that have been put in place as part of the report, and it is right that they should do so.

My second point relates to the fact that some hospitals in Wales are becoming routinely overcrowded, leading to concerns about patient safety and operations being cancelled. Obviously, that will have an impact on the care and treatment of older people. In an interview with BBC Wales this month, the director of the Royal College of Nursing in Wales, Tina Donnelly, said that she is concerned for the welfare of nurses. She said:

'They're telling us that they simply don't have time to care'.

She was asked in April to set up and chair the independent expert reference group. She has made crucial points about overcrowding and the pressure that nurses are under, particularly because of the high bed-occupancy rates that exceed the monthly average recommended by the Royal College of Surgeons of England for acute hospital beds.Reducing overcrowding is essential toensure that staff have the time and resources to care, and are able to take a breath and take advantage of any additional training that is available to them.

The report poses huge challenges for the new Welsh Government and the new Minister. I welcome Lesley Griffiths to her post, although I do not envy her the task of dealing with some of the recommendations that are in front of us. I hope that she will be able to make a start in dealing with those issues. It is crucial that we do so, because the issues raised in the report are shocking and need to be addressed as a matter of urgency.